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Image: AIDS 2012 International Conference
Pete Marovich for NBC News
Angelo Kaggwa, right, a 29-year-old man from Uganda speaks with Joshua Gitonga of Kenya at the 2012 International AIDS Conference in Washington, D.C. on Wednesday. Kaggwa is sharing his personal experience with circumcision with people at the 19th International AIDS Conference.
By
NBC News
updated 8/6/2012 2:42:59 PM ET 2012-08-06T18:42:59

It’s an idea that can make a grown man cringe and cross his legs, and no one knows better than Angelo Kaggwa. But Kaggwa finally got circumcised last year and immediately reduced his risk of infection with the AIDS virus dramatically. Now, he wants everyone to know: It’s not so bad.

Kaggwa, 29, is telling anyone who will listen at the International AIDS Conference in Washington, D.C. “This conference is a really good platform to reach out,” he said in an interview.

The studies are clear: Circumcising heterosexual men reduces their infection rate by at least 60 percent and some studies show it’s by 65 percent or more.

While that’s of little help to the gay and bisexual men who are still the most at risk from the human immunodeficiency virus that causes AIDS, the United Nations calculates that if 20 million high-risk men were circumcised by 2015, 20 percent of HIV infections would be prevented over the next 10 years. That could save $16.6 billion in future medical costs.

"We want the world to know that this procedure reduces the risk of female-to-male transmission by more than 60 percent and for the rest of the man's life, so the impact can be phenomenal,” U.S. Secretary of State Hillary Clinton told the conference on Monday.

Wives and partners of these men are protected by extension if the men have sex with someone else. Clinton praised a group of at least a dozen Zimbabwean legislators who got themselves circumcised last week.

"That's the kind of leadership we welcome,” she said. “On male circumcision, we've supported more than 400,000 procedures since last December alone. And I'm pleased to announce that PEPFAR (the President’s Emergency Fund for AIDS Relief) will provide an additional $40 million to support South Africa's plans to provide voluntary medical circumcisions for almost half a million boys and men in the coming year .”

But, according to the advocacy group AVAC (formerly the AIDS Vaccine Advocacy Coalition) only 8 percent of the 20 million targeted men actually have had the procedure.

Image: AIDS 2012 International Conference
Courtesy Angelo Kaggwa
Angelo Kaggwa is shown here during his own circumcision, which he said wasn't as painful as he had feared.

Kaggwa’s experience demonstrates that it may take more than statistics and speeches to persuade men. Word of mouth may be one of the most effective tools.

“I think people get a real visceral reaction,” AVAC’s Mitchell Warren told NBC News in an interview. “Someone once described it as minor surgery on a major organ.”

The procedure is usually done soon after birth in many societies, but it's being advocated for adults as a tool to help control the spread of HIV.

Kaggwa, originally from Kampala, Uganda, said he thought about circumcision for years but was put off by the fear of pain, the expense and the time it would take. He finally took the plunge at a PEPFAR-funded free clinic in Kisumu, Kenya. It wasn’t nearly as bad as he had feared, he said.

“The issue of pain kept coming up. I found out it was only in my head,” Kaggwa said. “It’s almost painless. It’s amazing. I was on a work trip, and as soon as the circumcision was done I was back to work … I just walked out of the theater and went back to my duties.”

Kaggwa, who lives in New York now and works for AVAC, said men will come up with any excuse not to be circumcised: they are busy, it will take too much time, it will hurt.

These are just lame excuses, he said. A one-on-one conversation can change minds, he said. “I personally know nine people who have been circumcised because of my story. I made a personal pledge to tell anyone who cares to listen.”

Circumcision protects men for a number of reasons. The foreskin is full of the immune system cells that are the most vulnerable to the virus. The tender tissue can also get tiny tears and scratches during sex that give the virus an easier entry point. And men with foreskins are far more likely to get other sexually transmitted diseases such as gonorrhea and syphilis, which, in turn, raise the likelihood of HIV infection.

“I definitely feel safer. I feel cleaner, too. I love the fact that I have protection by up to 60 percent," Kaggwa said.

Also, women may prefer circumcised partners, according to a new survey presented at the conference.

Timothy Okeyo and colleagues at the Nyanza Reproductive Health Society in Kenya interviewed 101 women whose partners had been circumcised.

“All female participants reported being satisfied with their partner's decision to become circumcised and his sexual performance after circumcision. Ninety-six percent were satisfied with the appearance of partner's penis and 91 percent reported enjoying sex more after circumcision,” Okeyo told the conference.

Three-quarters of the women said improved hygiene was a reason to get circumcised and 90 percent knew that a man was more likely to get HIV if he was not circumcised. Only 18 percent of the women and 6 percent of the men said they would be more likely to skip the condom when having sex. Researchers had feared that circumcision programs would increase risky sexual behavior, but Okeyo said the survey findings were reassuring.

As for one of the biggest questions surrounding adult circumcision, Kaggwa, who is single but has a steady girlfriend, is also reassuring.

“It hasn’t affected my sex life,” he says shyly.

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Photos: AIDS conference in Washington DC

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  1. People look at quilts in memory of AIDS victims at the "Keep the Promise" rally of AIDS advocates in Washington on July 22. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, a leading U.S. expert in the AIDS pandemic, said there is "no excuse" scientifically for not putting an end to the disease that has killed some 30 million people since it emerged in the 1980s. Speaking to reporters on the first day of the International AIDS Conference in the nation's capital, Fauci said science has the tools needed to combat HIV/AIDS. (Nicholas Kamm / AFP - Getty Images) Back to slideshow navigation
  2. U.S. Secretary of State Hillary Clinton speaks during the 19th International AIDS Conference in Washington D.C. (Jim Watson / AFP - Getty Images) Back to slideshow navigation
  3. Geojina Gutierrez, right, of Mexico City walks in the AIDS March in Washington, D.C., on July 22. (Jacquelyn Martin / AP) Back to slideshow navigation
  4. British pop icon Elton John walks to the podium to read names appearing on the AIDS Quilt on the National Mall on July 23 as part of the 19th International AIDS Conference in Washington, D.C. The conference is expected to draw 25,000 people, including politicians, scientists and activists, as well as some of the estimated 34 million people living with HIV who will tell their stories. (Karen Bleier / AFP - Getty Images) Back to slideshow navigation
  5. Adrian Gonzalez, an employee of the Condom Project, sets up a display at the International AIDS 2012 Conference in Washington, D.C., on July 23. The Condom Project (TCP) was established by a group of AIDS educators, activists and artists who work to de-stigmatize condoms among all people and to increase their use among sexually active individuals. (Kevin Lamarque / Reuters) Back to slideshow navigation
  6. Co-founder and Chairman of the Bill and Melinda Gates Foundation Bill Gates speaks alongside World Bank President Jim Yong Kim during the 19th International AIDS Conference in Washington, D.C. on July 23. (Jim Watson / AFP - Getty Images) Back to slideshow navigation
  7. Sex workers from around the world attend the Sex Workers' Freedom Festival in Calcutta, India, on July 22. Sex workers and social activists from 42 countries are congregrating in the city to participate in the weeklong festival organized to protest against the U.S. government's travel restrictions on sex workers wanting to attend the Intenational AIDS Conference in Washington, D.C. (Dibyangshu Sarkar / AFP - Getty Images) Back to slideshow navigation
  8. HIV-positive patient Aaron Laxton of St. Louis, center right, and other activists participate in a march from the Washington Convention Center to the White House on July 24, in Washington, D.C. AIDS activists from organizations all around the world participated in the march to "demand rights and resources to confront and cure HIV/AIDS." (Alex Wong / Getty Images) Back to slideshow navigation
  9. AIDS activists tie money and pill bottles to the White House fence. (Shawn Thew / EPA) Back to slideshow navigation
  10. AIDS activists are arrested by U.S. Park Police in front of the White House after marching from the 19th International AIDS Conference in Washington, D.C. (Shawn Thew / EPA) Back to slideshow navigation
  11. Bob Bowers of Madison, Wis., weeps as names of AIDS victims are read aloud at the AIDS Memorial Quilt on the National Mall in Washington, D.C. on July 24. Bowers, who has been HIV positive for 30 years, has lost dozens of friends to AIDS. (Kevin Lamarque / Reuters) Back to slideshow navigation
  12. Timothy Ray Brown, left, known as the 'Berlin Patient,' is the only person to have been cured of AIDS. He is greeted while waiting to enter a press conference to announce the launch of the Timothy Ray Brown Foundation at the Westin City Center hotel in Washington, D.C. "I wouldn't wish this on my worst enemy," Brown said of the treatment process that eventually cured him. (T.j. Kirkpatrick / Getty Images) Back to slideshow navigation
  13. Thousand of activists, sex workers and their children -- with many of them carrying symbollic red umbrellas -- attend a rally as a part of the International AIDS Conference organized by the Durber Mahila Samannay Committee in the Sonagachi redlight district in Calcutta, eastern India. A six-day conference is being held in Calcutta with hundreds of sex workers gathering from 30 countries to oppose the U.S. decision to not grant them travel visas. (Piyal Adhikary / EPA) Back to slideshow navigation
  14. Children of Indian sex workers gesture as they participate in a rally as part of the Sex Workers' Freedom Festival in Calcutta, India. (Dibyangshu Sarkar / AFP - Getty Images) Back to slideshow navigation
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